Original Article With Video Illustration| Volume 29, ISSUE 3, P471-477, March 2013

Download started.


Reproducible Noninvasive Method for Evaluation of Glenoid Bone Loss by Multiplanar Reconstruction Curved Computed Tomographic Imaging Using a Cadaveric Model

Published:January 31, 2013DOI:


      To determine if the measurement of the glenoid surface by computed tomography (CT) with curved multiplanar reconstructions (cMPR) in a cadaveric model is an accurate and reproducible technique.


      Ten dried cadaveric glenoid specimens were used. Two glenoids were subsequently modified mechanically to induce a bony Bankart lesion. Three skilled musculoskeletal radiologists performed cMPR on computed tomographic images of the glenoids; one of the radiologists repeated the same measurements after 3 months. Two of the 3 operators used the traditional “flat” MPR method as a control. An optical scanning system using a high-precision laser (CAM2 Laser Line Probe, Faro Technologies, Lake Mary, FL) was used as a reference. From the data obtained, an evaluation was performed for variability, degree of interoperator and intraoperator agreement, and degree of agreement between the laser and CT methods. Statistical analysis was performed with PASW-SPSS, version 18 (IBM, Armonk, NY) and R, version 2.12 statistical package.


      The average difference between the 2 sets of cMPR measurements was approximately 1%, and maximum and minimum values were between 6.02% and −0.29%. The flat MPR method showed mean differences of 16% when compared with laser scanning, and maximum and minimum values were 31% and 8%, respectively. The interoperator variability for the “curved” method was limited and showed a coefficient of variation ranging from 0.78% to 2.82%. The Cronbach alpha coefficient for this set of measurements was alpha = 0.995. There was little intraoperator variability with the coefficient of variation between 0% and 2% and an intraclass correlation coefficient of 0.989.


      The use of cMPR computed tomographic imaging of the glenoid in a cadaveric model was found to be significantly more accurate than conventional MPR (flat MPR). Moreover, cMPR CT is a reproducible technique providing reliable information despite the relevant variable anatomy of the glenoid surface. This technique could reasonably also be used in a clinical setting as a more accurate noninvasive method.

      Clinical of Relevance

      This technique could also reasonably be used in a clinical setting as a more accurate noninvasive method.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bigliani L.U.
        • Newton P.M.
        • Steinmann S.P.
        • Connor P.M.
        • McLlveen S.J.
        Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder.
        Am J Sports Med. 1998; 26: 41-45
        • Burkhart S.S.
        • De Beer J.F.
        Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion.
        Arthroscopy. 2000; 16: 677-694
        • Griffith J.F.
        • Antonio G.E.
        • Tong C.W.
        • Ming C.K.
        Anterior shoulder dislocation: Quantification of glenoid bone loss with CT.
        AJR Am J Roentgenol. 2003; 180: 1423-1430
        • Huijsmans P.E.
        • Haen P.S.
        • Kidd M.
        • Dhert W.J.
        • van der Hulst V.P.
        • Willems W.J.
        Quantification of a glenoid defect with three-dimensional computed tomography and magnetic resonance imaging: A cadaveric study.
        J Shoulder Elbow Surg. 2007; 16: 803-809
        • Itoi E.
        • Lee S.B.
        • Berglund L.J.
        • Berge L.L.
        • An K.N.
        The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: A cadaveric study.
        J Bone Joint Surg Am. 2000; 82: 35-46
        • Kralinger F.
        • Aigner F.
        • Longato S.
        • Rieger M.
        • Wambacher M.
        Is the bare spot a consistent landmark for shoulder arthroscopy? A study of 20 embalmed glenoids with 3-dimensional computed tomographic reconstruction.
        Arthroscopy. 2006; 22: 428-432
        • Lo I.K.
        • Parten P.M.
        • Burkhart S.S.
        The inverted pear glenoid: An indicator of significant glenoid bone loss.
        Arthroscopy. 2004; 20: 169-174
        • Sugaya H.
        • Moriishi J.
        • Dohi M.
        • Kon Y.
        • Tsuchiya A.
        Glenoid rim morphology in recurrent anterior glenohumeral instability.
        J Bone Joint Surg Am. 2003; 85-A: 878-884
        • Bushnell B.D.
        • Creighton R.A.
        • Herring M.M.
        Bony instability of the shoulder.
        Arthroscopy. 2008; 24: 1061-1073
        • Burkhart S.S.
        • Debeer J.F.
        • Tehrany A.M.
        • Parten P.M.
        Quantifying glenoid bone loss arthroscopically in shoulder instability.
        Arthroscopy. 2002; 18: 488-491
        • Ungersbock A.
        • Michel M.
        • Hertel R.
        Factors influencing the results of a modified Bankart procedure.
        J Shoulder Elbow Surg. 1995; 4: 365-369
        • Provencher M.T.
        • Detterline A.J.
        • Ghodadra N.
        • et al.
        Measurement of glenoid bone loss: A comparison of measurement error between 45 degrees and 0 degrees bone loss models and with different posterior arthroscopy portal locations.
        Am J Sports Med. 2008; 36 (Epub 2008 Mar 19): 1132-1138
        • Chuang T.Y.
        • Adams C.R.
        • Burkhart S.S.
        Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability.
        Arthroscopy. 2008; 24: 376-382
        • Baudi P.
        • Righi P.
        • Bolognesi D.
        • et al.
        How to identify and calculate glenoid bone deficit.
        Chir Organi Mov. 2005; 90 (in Italian): 145-152
        • Magarelli N.
        • Milano G.
        • Sergio P.
        • Santagada D.A.
        • Fabbriciani C.
        • Bonomo L.
        Intra-observer and interobserver reliability of the ‘Pico’ computed tomography method for quantification of glenoid bone defect in anterior shoulder instability.
        Skeletal Radiol. 2009; 38: 1071-1075
        • Kwon Y.W.
        • Powell K.A.
        • Yum J.K.
        • Brems J.J.
        • Iannotti J.P.
        Use of three-dimensional computed tomography for the analysis of the glenoid anatomy.
        J Shoulder Elbow Surg. 2005; 14: 85-90
        • Itoi E.
        • Lee S.B.
        • Amrami K.K.
        • Wenger D.E.
        • An K.N.
        Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography.
        Am J Sports Med. 2003; 31: 112-118
        • Nofsinger C.
        • Browning B.
        • Burkhart S.S.
        • Pedowitz R.A.
        Objective preoperative measurement of anterior glenoid bone loss: A pilot study of a computer-based method using unilateral 3-dimensional computed tomography.
        Arthroscopy. 2011; 27: 322-329
        • Kuszyk B.S.
        • Heath D.G.
        • Bliss D.F.
        • Fishman E.K.
        Skeletal 3-D CT: Advantages of volume rendering over surface rendering.
        Skeletal Radiol. 1996; 25: 207-214

      Linked Article

      • Erratum
        ArthroscopyVol. 29Issue 4
        • Preview
          In the article “Reproducible Noninvasive Method for Evaluation of Glenoid Bone Loss by Multiplanar Reconstruction Curved Computed Tomographic Imaging Using a Cadaveric Model” by De Filippo et al. in the March 2013 issue (Arthroscopy 2013;29:471-477), the first author's surname was styled incorrectly. It should read Massimo De Filippo.
        • Full-Text
        • PDF